Investigation into the quantitative and qualitative characteristics of choroidal melanoma through magnetic resonance imaging and B-scan ultrasound

Papayiannis, Vassilis; Tsaousis, Konstantinos T.; Kouskouras, Constantinos; Haritanti, Afroditi; Diakonis, Vasilios F.; Tsinopoulos, Ioannis

doi:10.2147/opth.s130009

Cited by 6 publications

(5 citation statements)

References 18 publications

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“…"Romanowska-Dixon et al" in a retrospective study of 171 enucleated eyes with CM and deep intrascleral tumor invasion with extrascleral extension showed that extrascleral extension was detectable before enucleation in 31 eyes (18.24%) and ultrabiomicroscopy is crucial in detecting the routes of extrascleral extension of UM [44]. "Papayiannis et al" in a comparative study between MRI and USG B-scan found USG to be more sensitive than MRI in detection of RD [45]. MRI of malignant malenoma which contain melanin and has intrinsic T1 and T2 shortening effects, classically manifests with hyperintense signal on T1-weighted magnetic resonance (MR) images and with hypointense signal on T2-weighted images.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Choroidal Melanoma in a Hill Population of Northern India

Arora¹,

Sharma²,

Sharma³

et al. 2021

IJOVS

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Aim: To assess prevalence and presentation of choroidal melanoma in a hill population of northern India along with its demographics, features, diagnostics, treatment and outcome with comparison to western population. Method: Choroidal melanoma constitutes most common intraocular malignancy with early appearance in Asian population. This is the 1 st case series from a hill state of Uttarakhand, northern India involving medium to large size tumour with extraocular extension. In this retrospective study we assessed the prevalence, clinical presentation, diagnostic modalities, treatment plan, disease outcome, prognosis with survival and mortality. The study was carried out in time duration from February 2019-March 2021. Results: Data shows the presence of five patients, four male and 1 female in age range of 47-77 years, with median age at 62 years. Patient presented with visual equity in range of 6/18 to perception of light in time range of six months to 2 years. Fundus examination revealed presence of medium to large size choroidal mass with surface pigmentation and serous detachment. Neovascular glaucoma was present in three patients. Three patients underwent brachytherapy with I 125 and Ru 106, two cases responded well to therapy, one case presented with recurrence of tumour and neovascular glaucoma, underwent preenucleation radiation with external beam radiation therapy (EBRT) and the eye was lost following enucleation. Among five patients three underwent enucleation and thereafter were referred to surgical oncology for enlarged regional and cervical chain of lymph nodes for suspected metastasis. Histopathology via fine needle aspiration cytology (FNAC) or biopsy from whole specimen showed two cases of spindle cell, one of mixed cell variety and two of epitheloid cell type. Two cases of eitheloid cell type and one of spindle cell type needed EBRT as there was extraocular extension. All cases with enucleation were adviced an ocular implant. A diligent post treatment follow was maintained to look out for local recurrence and distant metastasis. Conclusion: Hill states have poor accessibility to healthcare. Our study shows existence of choroidal melanoma may be much larger than anticipated and cases could have been missed, hence making the need for dilated fundus examination a requirement and necessity. Histopathology, serology and imaging are much needed tools for diagnosis and staging of disease along with treatment of choroidal melanoma eventually indicating prognosis, survival and mortality. Treatment modalities as brachytherapy and EBRT are more frequently being used, indicating a shift in treatment more towards organ salvaging and preservation so as to maintain best visual function.

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Section: Discussionmentioning

confidence: 99%

Prevalence of Choroidal Melanoma in a Hill Population of Northern India

Arora¹,

Sharma²,

Sharma³

et al. 2021

IJOVS

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“…One of the most well-established modalities for imaging choroidal nevus and melanoma is ultrasound, which is often used with a high-frequency transducer at brightness modulation (B-mode). 11 B-scan ultrasound is useful for imaging the posterior segment of the orbit and is often used for measurement of tumor thickness. 12 A common error in tumor measurement using B-scan ultrasound is inadvertently measuring the tumor to the outer scleral surface instead of the inner scleral surface.…”

Section: Discussionmentioning

confidence: 99%

“…9 To avoid these errors, it is important that the examiner has experience and expertise in measuring intraocular tumors. 11 Moreover, different institutions may use varying techniques for tumor measurement. For example, some institutions prefer to consistently include the sclera in their measurements of tumor thickness, whereas others do not.…”

Section: Discussionmentioning

confidence: 99%

Conversion Factor for B‐Scan Ultrasound Measurement of Intraocular Tumors With and Without the Sclera

Tanke

Dalvin

2020

J of Ultrasound Medicine

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Objectives-To investigate the relationship between choroidal nevus and melanoma thickness measured with or without the sclera included by B-scan ultrasound and to present a simple conversion formula.Methods-Medical records were retrospectively reviewed for choroidal nevus or melanoma evaluated at the Mayo Clinic in Rochester, Minnesota, with B-scan ultrasound between February 4, 2004, and April 23, 2020. Charts were retrospectively reviewed for high-quality B-scan images in which the ultrasound transducer was perpendicular to the lesion, measuring the tumor thickness without the sclera included. Measurements were repeated with the sclera included for each patient. Univariate and multiple linear regression analyses were performed to identify factors correlated with scleral thickness.Results-There were 201 tumors included in the study, with a mean patient age AE SD of 61 AE 14 years, largest tumor basal diameter of 11.8 AE 4.8 mm, tumor thickness without the sclera included of 3.72 AE 2.7 mm, and thickness with the sclera included of 4.54 AE SD 2.8 mm. On the univariate analysis, factors associated with perceived scleral thickness by B-scan ultrasound included age (P < .001), tumor thickness (P < .001), and basal diameter (P = .06). On the multivariate analysis, factors associated with perceived scleral thickness included age and tumor thickness (P < .001) for all tumors and for the subset of 141 tumors with a thickness of 2 mm or greater (P < .001). For tumors of 2 mm or greater in thickness, perceived scleral thickness by ultrasound can be estimated by the formula 0.00495(patient age) + 0.02451(tumor thickness without the sclera) + 0.42549.Conclusions-We present a simple formula for converting between B-scan ultrasound measurements of choroidal nevus and melanoma measuring 2 mm or greater in thickness with and without the sclera included.

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“…The typical tumor appears as a solid, single, unilateral, pigmented, elevated lesion, with orange pigment, in the shape of a dome (75%), mushroom (20%) or difuse (5%), with its own vascularization, and may appear with associated retinal detachment or, rarely, with vitreous hemorrhage [7,11]. Ultrasonography helps in the diagnosis showing an intraocular mass of low to medium reflectivity, homogeneous, with signs of internal vascularization, forming acoustic hollowness, kappa angle, and choroidal excavation [12,13].…”

Section: Introductionmentioning

confidence: 99%

Choroidal melanoma tumor profile and treatment pattern for newly diagnosed patients at a reference public hospital in Sao Paulo, Brazil

et al. 2022

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Background Choroid, ciliary body, and iris melanomas are often grouped as uveal melanoma, the most common intraocular primary malignancy. The purpose of the current study was to analyze the tumor profile of newly diagnosed cases of choroidal melanoma at a reference center in Sao Paulo, Brazil, and to investigate the frequency of eyes treated by enucleation that could have been treated with brachytherapy if available in the service. Methods Medical records of patients referred to our service with initial diagnostic hypothesis of choroidal melanoma from July 2014 to June 2020 were analysed on demographics, diagnosis confirmation, tumor measurement by ultrasonography and established treatment. Data were evaluated on clinical and demographic characteristics as age, sex, affected eye, ultrasound parameters, and treatment management of patients with clinically diagnosed choroidal melanoma. Among the patients submitted to enucleation, we investigated how many could have been selected to receive brachytherapy. Results From the 102 patients referred with the choroidal melanoma diagnosis hypothesis, 70 (68.62%) were confirmed. Mean measurements from the tumors in millimetres were: 9.19 ± 3.69 at height and 12.97 ± 3.09 by 13.30 ± 3.30 at basal. A total of 48 cases (68.57%) were enucleated, 8 (11.43%) were treated by brachytherapy in a different service, and 14 patients (20.00%) returned for enucleation at their original referral center. Out of the 48 patients enucleated, 26 (54.17%) could have been selected to brachytherapy treatment. Conclusions The results indicate a late diagnosis of choroidal melanoma cases referred to our service. Most enucleated cases could have been treated with brachytherapy if it was broadly available at the national public health insurance. Further public health political efforts should focus on early diagnosis and better quality of life post-treatment for oncologic patients.

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Investigation into the quantitative and qualitative characteristics of choroidal melanoma through magnetic resonance imaging and B-scan ultrasound

Cited by 6 publications

References 18 publications

Prevalence of Choroidal Melanoma in a Hill Population of Northern India

Prevalence of Choroidal Melanoma in a Hill Population of Northern India

Conversion Factor for B‐Scan Ultrasound Measurement of Intraocular Tumors With and Without the Sclera

Choroidal melanoma tumor profile and treatment pattern for newly diagnosed patients at a reference public hospital in Sao Paulo, Brazil

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